目的 评估体外冲击波对移植术后单侧股骨头缺血性坏死患者减轻疼痛和减缓骨内损害进程的有效性。方法 临床评估包括VAS评分、Harris评分、RMS平片和髋关节磁共振。每个疗程包括4次治疗,每次治疗包括2400次脉冲,能量0.50 mJ/mm2,每次治疗间隔48~72 h。随访检查分别安排在第3、6、12、24个月。结果 36例(男23例,女13例)被纳入本研究,年龄45～65岁,体重45～101 kg,身高150～175 cm。共有10例治疗失败,26例症状不同程度改善。随访24个月,没有发现不良反应。在所有随访时间点上,ARCO Ⅰ期组和Ⅱ期组患者均明显优于ARCO Ⅲ期组患者(P<0.005)。结论 对于ARCO Ⅰ期和Ⅱ期的移植术后患者,ESWT可能有助于防止缺血性坏死区域的进展并控制疼痛。
Abstract
Objective To evaluate the effectiveness of extracorporeal shock waves in relieving pain and slowing the progression of intraosseous lesions in 36 patients with avascular necrosis of the femoral head after transplantation. Methods Clinical assessment involved pain scores, Harris Hip Scores,Roles and Maudsley score, X-ray and MRI.Each treatment cycle consisted of four sessions, with 2,400 impulses administered at 0.50 mJ/mm2 and at 48-72 h intervals. Follow-up examinations were scheduled at 3, 6,12 and then 24 months. Results A total of 36 patients (23 males and 13 females) were enrolled in the study, who were aged 45 to 65, weighed 45 to 101 kg, and 150 to 175 cm tall. Treatment failed in 10 cases and 26 cases were improved.The follow-up period was 24 months and no adverse reactions were found. At each follow-up time point, patients in the ARCOⅠandⅡ groups were significantly better than those in the ARCO Ⅲ group (P<0.005). Conclusions For post-transplantation patients in ARCO stages Ⅰ and Ⅱ, ESWT may help to contain the spread of the area of avascular necrosis and manage pain.
关键词
冲击波疗法 /
股骨头缺血性坏死 /
非手术治疗 /
移植术后
Key words
shock wave therapy /
avascular necrosis of the femoral head /
conservative treatment /
post-transplantation
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